let’s go back to the world of individual insurance before the major provisions of the Affordable Care Act went into effect on Jan. 1, 2014. In that world, the primary source of profit for insurers was not providing better care so that patients stayed healthy, or negotiating better prices with hospitals and drug companies; it was their ability to avoid the sick and insure only the healthy. And insurers had three tools for doing so: denying coverage to the insured for any costs associated with pre-existing conditions; denying insurance entirely to sick people; and charging the sick much higher prices than the healthy, a practice called health underwriting.

This article gets right to the point. The current setup of employer provided healthcare doesn’t work.

It doesn’t benefit workers and it doesn’t incentivize healthcare competition or savings. The writers’ plan is verbatim what we have been saying we need for years.

Get employers out of the business of providing health insurance. We wouldn’t tolerate them interceding in our auto or home owners insurance. Why are we tolerant of it here?

Most likely because NobodyisFlyingthePlane. We can’t see the direct mechanism between rising healthcare costs and falling wages. Single payer or tax incentives to cover rising costs aren’t the solution; they’re only patches.

A Kaiser Foundation report released in September explained that since 1999, health care premiums for employer-sponsored insurance programs have risen more than three times faster than wages. Today’s workers are paying an average of $18,000 for health insurance that covers fewer services each year, as employers shift costs to their employees through higher deductibles, co-payments and shares of premiums.

Another example of why health insurance and employment shouldn’t be tied together.

Employee wellness programs are mostly great, but ‘required’ participation is problematic. Requiring employees to provide private data and health info or fining them if they dont is not voluntary participant as required by the law.

Effectively employees required to give biometric info to participate removes consumer choice from the market place. Employees can’t move to other health plans which dont misuse their data without leaving their jobs.

This article has a great about what is wrong with employer sponsored healthcare.

Imagine yourself in a bar where a pickpocket takes money out of your wallet and with it buys you a glass of chardonnay. Although you would have preferred a pinot noir, you decide not to look that gift horse in the mouth and thank the stranger profusely for the kindness, assuming he paid for it. You might feel differently, of course, if you knew that you actually had paid for it yourself.

premiums ostensibly paid by employers to buy health insurance coverage for their employees are actually part of the employee’s total pay package – the price of labor, in economic parlance – and that the cost of that fringe benefit is recovered from employees through commensurate reductions in take-home pay.

why, uniquely in the industrialized world, Americans have for so long favored an arrangement in health insurance that endows their employers with the quasi-parental power to choose the options that employees may be granted in the market for health insurance.

And what kind of health “insurance” have Americans gotten under this strange arrangement? Once again, uniquely in the industrialized world, it has been ephemeral coverage that is lost with the job or changed at the employer’s whim. Citizens in any other industrialized country have permanent, portable insurance not tied to a particular job in a particular country.

The last sentence of this article is the key. We spend a lot for healthcare without incentivizing good health and positive outcomes. We spend lots of money on our health, but its not getting us the results we should and could have.

the key, though under-recognized, problem in American health care today: not that Americans spend a lot on health care, but that they spend a lot without always getting good value for the money.